Form 13615 - Volunteer Standards Of Conduct Agreement Vita/tce Programs Page 2

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Volunteer:

By signing this form, I declare that I have completed Volunteer Standards of Conduct Certification and have read, understand, and will

comply with the volunteer standards of conduct.

Full name

Volunteer position(s)

IRS Employee -

(please print)

VITA/TCE Volunteer

Home street address: city, state and ZIP code

Email address

Daytime telephone

Sponsoring partner name/site name

Number of years volunteered

Volunteer signature

Date

(including this year)

Volunteer Certification Levels

Intake/

Puerto Rico

Standards of

Interview

Foreign

Conduct

Basic

Advanced

Military

International

HSA

& Quality

Students

(Required for ALL)

Review

Add the letter “P” for all

passing test scores

Site Coordinator, Sponsoring Partner, Instructor or IRS: By signing this form, I declare that I have verified the required certification level(s) and proper

identification for this volunteer prior to allowing the volunteer to work at the VITA/TCE site.

Approving Official’s signature and date

Approving Official's (printed) name and title

(site coordinator, sponsoring partner, instructor, etc.)

For Continuing Education (CE) Credits ONLY

(to be completed by the site coordinator or partner)

Instructions: Complete this section when an unpaid certified volunteer is requesting Continuing Education (CE) credits. CE credits will not be issued without a PTIN for

Enrolled Agents or Non-credentialed preparers. CPAs or other similar professionals do not require a PTIN; however, they must check with their governing board requirements

for obtaining CE Credits. The Site Coordinator or Partner must sign and date this form and send the completed form to SPEC Territory Office/Relationship Manager for further

processing. See Publication 1084, Site Coordinators Handbook, for additional requirements and instructions.

Name as listed on PTIN card

Volunteer Preparer's Tax Identification Number (PTIN)

P -

Site Identification Number (SIDN)

Address

(VITA/TCE Site or teaching location)

S -

Volunteer Status

(check only one box)

Enrolled Agent (EA)

Non-credentialed Tax Return Preparer

Certified Public Accountant (CPA)

Other Professional

Volunteer Hours

Volunteer Position

(add the numbers of completed volunteer hours below)

(Check only one box in the appropriate section below)

(minimum of 10 volunteer hours required to issue CE Credits)

Quality Reviewer

Return Preparer

Tax Law Instructor

Total hours volunteered

(qualifies for 14 CE credits)

(all must be certified in Advanced)

Quality Reviewer

Return Preparer

Tax Law Instructor

Total hours volunteered

(all must be certified in Advanced AND one or more specialty course)

(qualifies for 18 CE credits)

If applicable, check tax law courses instructed

Basic

Advanced

Military

International

HSA

Puerto Rico

Foreign Students & Scholars

Site Coordinator, Sponsoring Partner, or Instructor: By signing this form, I declare that I have validated that the reported volunteer hours are based on

the activities this volunteer performed in my site or training facility.

Approving Official's (printed) name and title

(site coordinator, sponsoring partner, instructor)

Approving Official’s signature

Date signed

13615

Catalog Number 38847H

Form

(Rev. 10-2015)